Pyogenic spinal infections warrant a total spine MRI

Area of Science:

• Orthopedics
• Infectious Diseases
• Radiology

Background:

• Spinal infections present with nonspecific symptoms, potentially delaying diagnosis and worsening patient outcomes.
• Multifocal spinal infections carry significantly higher morbidity and mortality rates than unifocal infections.

Purpose of the Study:

• To identify risk factors associated with multifocal pyogenic spinal infections.
• To improve diagnostic strategies and patient management for spinal infections.

Main Methods:

• Retrospective case series of 43 patients with pyogenic non-tuberculous spinal infections treated surgically between 2006 and 2020.
• Analysis of medical records, imaging, and laboratory data.
• Univariate and multivariate analyses to determine factors linked to multifocal infections.

Main Results:

• Fifteen patients (35%) presented with multifocal infections.
• Univariate analysis showed associations with chronic kidney disease, gender, elevated white blood cell count, and cervical or thoracic spine involvement.
• Multivariate analysis confirmed cervical and thoracic involvement as statistically significant predictors of multifocal infection.

Conclusions:

• Infections located in the thoracic or cervical spine increase the likelihood of a multifocal presentation.
• Multifocal pyogenic spinal infections are a significant clinical concern.
• A total spine MRI is recommended for prompt and accurate diagnosis of multifocal spinal infections.